1. INTRODUCTION TO ANEMIA Definition. Age, Sex and other factors. Causes of Anemia. Clinical diagnosis. Classification of Anemia. Laboratory Tests in the diagnosis of anemia.

2. Anemia Inability of blood to supply the tissue with adequate oxygen for proper metabolic function. i.e. anemia is considered to be present if hemoglobin concentration of RBC or PCV (Hct) is below the lower limit of the normal range (95 % reference interval). Diagnostic criteria for anemia are  Hb, Hct or RBC.

3. Considerations by Age, sex and other factors New born infant  1 weekHb 14-22 g/dl 6 month oldHb 11-14 g/dl 1-15 yearsHb 11-15 g/dl Adult MaleHb 13-17 g/dl FemaleHb 12-15 g/dl

4. Other factors Geographical factor a.High altitude (8000 feet) may have high Hb level. b.Different population (Asia and Europe). Various diseases.

5. Causes of anemia Blood loss (internal or external hemorrhage). Nutritional deficiency (Folate, B12 or Iron). Accelerated destruction of RBC (immune & non immune hemolysis). BM replacement (cancer). Infections. Toxicity. Hematopoietic stem cell arrest or damage. Hereditary (G6PD, Sickle cell anemia). Idiopathic.

6. Clinical diagnosis -Patient history Signs and symptom: non specific Fatigue, weakness, faintness, headache and heart palpitation -Physical signs Pallor, low BP, a slight fever. -Changes in hematologic profiles Laboratory investigation: Quantitation and Semi-quantitation of RBC indices

7. Quantitation Three lab manifestations of anemia include: - a decrease Hb concentration. - a reduced Pack Cell Volume (Hct) level. -a decreased RBC count and other indices.

8. Semi-Quantitative Microscopic Examination: *RBC morphology: -Normochromic Normocytic. -Hypochromic Microcytic. -Hyperchromic Macrocytic. Depends on classification

9. RBC indices and other tests: Hb Hct RBC indices (MCV, MCH, MCHC) Blood Smear Reticulocytes count BM smear References: Essential Haematology (Hoffbrand & Pettit) Clinical Hematology & Fundamentals of Hemostasis (Denise Harmening).